Valproic acid reduces hair loss and improves survival in patients receiving temozolomide-based radiation therapy for high-grade glioma

In a retrospective study involving 112 patients with high-grade glioma, valproic acid (VPA) administered during temozolomide-based radiation therapy was found to delay the onset of hair loss and improve survival outcomes. Patients in the VPA group experienced hair loss at a higher radiation dose (30 Gy) and after more fractions (15) compared to the non-VPA group (26 Gy and 7.5 fractions, respectively), with statistical significance (P < 0.01). The median overall survival was significantly longer for the VPA group at 42.2 months versus 20.3 months for the non-VPA group, with a hazard ratio of 0.36 (95% CI, 0.18-0.74; P < 0.01). Although median progression-free survival was longer in the VPA group (22.7 months) compared to the non-VPA group (11.0 months), this difference was not statistically significant. The study suggests that VPA's benefits may be due to its role in maintaining DNA repair activity, promoting hair growth through the Wnt/ß-catenin signaling pathway, and exerting anti-inflammatory effects. However, the authors note the need for further research with larger sample sizes to confirm these findings.